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I will post new, exciting words everyday. Also I will be posting my interesting findings on my journey though the imperfect science which is medicine. Including ethics issues and some politics.

Zoledronic Acid May Help Reduce Breast Cancer Growth

* Explain to interested patients that zoledronic acid is given to breast cancer patients on endocrine therapy to protect bone health.

Note that zoledronic acid has been shown to have potential antitumor activity in preclinical and early phase studies.

The addition of zoledronic acid (Zometa) reduced the risk of disease progression by 36% compared with adjuvant endocrine therapy alone (absolute difference -3.2 percentage points, P=0.01), found Michael Gnant, M.D., of the Medical University of Vienna, and colleagues.

While the randomized trial showed no mortality benefit, toxicity was minimal, they reported in the Feb. 12 issue of the New England Journal of Medicine.

The results confirm the initial report of the data at last year's American Society of Clinical Oncology meeting.

This effect was comparable to the absolute advantage in disease-free survival seen in prior trials for aromatase inhibitors versus tamoxifen among postmenopausal women with early breast cancer, the researchers noted.

Given the similar advantage of aromatase inhibitors in one prior study of premenopausal women, their Austrian Breast and Colorectal Cancer Study Group trial was also designed to compare endocrine treatments.

The study included 1,803 premenopausal women with endocrine-responsive stage I or II breast cancer who were given the gonadotropin-releasing hormone analog goserelin (Zoladex, 3.6 mg subcutaneously every 28 days) after primary surgery.

They were randomized to adjuvant treatment with tamoxifen (20 mg per day given orally) or anastrozole (Arimidex) at 1 mg per day given orally) with or without zoledronic acid (4 mg given intravenously every six months) for three years.

However, unexpectedly, anastrozole did not improve outcomes among premenopausal women in the study at a median follow-up of 47.8 months. The findings compared with tamoxifen included:

The difference compared with postmenopausal women might have been "because of the dominant effect of ovarian suppression on estrogen levels in premenopausal women," the researchers suggested. "Moreover, long-term administration of goserelin can reduce androgen levels, thereby limiting the available substrate for aromatase activity."

Other findings for the addition of zoledronic acid compared with endocrine therapy alone included:

The number needed to treat with zoledronic acid to prevent disease progression in one patient was 31 in the study, "consistent with the number needed to treat for cancer therapies that in the past have caused a shift in treatment standards," such as docetaxel (Taxotere) and paclitaxel (Taxol), Dr. Gnant's group noted.

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